How to optimize my AHI, mixed results so far

[turk0ZzZz]

Hello board,

I guess some background before we get into the details. I was diagnosed with sleep apnea on August 11. The sleep report came back with an AHI of 18.2 (20.6 in supine), so bought my APAP machine probably two days after that and have used it every night since. I started using the F20 full mask, then decided to try some pillows so tried the P30i and the Switch FX.. Settled down with the Switch FX. Overall have kept my AHI below 5 but have been having mixed results within that. I can get sub 2 AHI sometimes (as low as 0.29 last night) but most of the time it is between 2-5. I am not sure what the difference is between these results but would like to know how to keep my AHI below 2.. especially since I know it is possible. I have attached three nights 1) My best AHI score so far, which was last night and 2) and 3) which are both above 3 AHI. I have had some nights between 4-7 as well, but did not have an SD card inserted into the device to monitor yet. Hopefully some of the keener eyes on the board can see what I can't and give me some tips. Let me know if you need anything else from the charts.

Thanks.

[staceyburke]

You main events are central. That’s good and bad.

The bad first. There are no pressures that help these.

The good. They appear to be treatment emergents which means they will get much less frequent as you get use to therapy.

Ho help control them I would suggest to set your EPR to 0. That should reduce then band later you can add EPR back.

[AndyB]

I'm not an expert, but you may simply need more time for your body and brain to become used to sleeping with an APAP machine.  Until that happens (it took me 2-3 months), your nightly results are not likely to be consistent.  I was impatient at first, and frequently changed my settings in the beginning; after a while my nightly results settled into a reasonably consistent and beneficial range.  Good luck!

[turk0ZzZz]

The good. They appear to be treatment emergents which means they will get much less frequent as you get use to therapy.

Ho help control them I would suggest to set your EPR to 0. That should reduce then band later you can add EPR back.

Why do you say they appear to be treatment emergent? I guess I should've specified in my first post... This was the result of my sleep test:
A total of 152 apneas, made up of 41 obstructive, 34 central, 9 mixed, 68 hypopnea.

You say to later add back EPR. How long would you say I need to try with 0 EPR?

I'm not an expert, but you may simply need more time for your body and brain to become used to sleeping with an APAP machine.  Until that happens (it took me 2-3 months), your nightly results are not likely to be consistent.  I was impatient at first, and frequently changed my settings in the beginning; after a while my nightly results settled into a reasonably consistent and beneficial range.  Good luck!

Thanks for letting me know of your experience... Esp with the 2-3 months adjustment phase.

[Gideon]

First central apnea has a characteristic we call consistently inconsistent. In other words it jumps all around.

Your sleep test showed a CAI of around 6, mixed plus centrals. You are getting 3-4 CAI when you get them.

The fact that they come and go tends to indicate they are treatment emergent. A 10 minute view of them could support this.

In this case I would stay the course for now and see how you do.

The real question is how do you feel? Be critical.

[staceyburke]

The top night you had very few if you had them before they would most likely have been present in every night. How long do they last depends how much you use Cpap each night. The more you do the faster your body gets accustomed to the therapy. 2 moths maybe 3.

[turk0ZzZz]

First central apnea has a characteristic we call consistently inconsistent.  In other words it jumps all around.

Your sleep test showed a CAI of around 6, mixed plus centrals.    You are getting 3-4 CAI when you get them.

The fact that they come and go tends to indicate they are treatment emergent.  A 10 minute view of them could support this.

In this case I would stay the course for now and see how you do.

The real question is how do you feel?  Be critical.

Is this what you mean by a 10 minute view? (Attached)

Regarding how I feel, I feel much better overall than before APAP treatment. Much more alert and better focus, especially in the mornings, less drowsy and less tired when waking up. But I can tell the difference between a good day and a not so good day...

[Gideon]

No, this is an 8 hr + view (see the duration on the flow rate chart) The organize link in my signature has a section on zoomed/close up views.

[turk0ZzZz]

I actually attached the wrong image. Is this what you mean?

[turk0ZzZz]

Two nights with EPR Off... My leakeage has gone up since deactivating it.